Exocrine Pancreatic Insufficiency: Seen but Not Recognized?

David A. Johnson, MD

Disclosures

May 21, 2014

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In This Article

The Pancreas

Hello. I am Dr. David Johnson, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia. Welcome back to another installment of GI Common Concerns -- Computer Consult .

Today I want to talk with you about a condition that is often seen but may not always be recognized: chronic exocrine pancreatic insufficiency.

The pancreas is the organ that is responsible for facilitating digestion. It secretes a variety of enzymatic digestive particles: lipase, amylase, and protease. These are secreted into the duodenum in response to a meal or some type of neural transmission through secretin or cholecystokinin (CCK).

The pancreas is very adept and has a remarkable reserve capability. Lipase, the enzyme responsible for the digestion of fat, digests fat into fatty acids and monotriglycerides, which are then facilitated for absorption with bile salts. The pancreas is capable of secreting an estimated 900,000 units of pancreatic lipase with a meal, only about 10% of which is needed.

Exocrine pancreatic insufficiency means that you have brokered that reserve bank and you are down to less than 10% of your capability to secrete the normal enzymatic secretions by the pancreas.

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